Individual provider Active NPI

Edwin Francisco Suaza, PA-C

  • Physician Assistant
  • Spencer, IA
National Provider Identifier
1982161204
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
116 E 11TH St Ste 101
Spencer, IA 51301-4365
Phone
(712) 264-3500
NPI assigned
Feb 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

116 E 11TH St Ste 101
Spencer, IA 51301-4365

Mailing address

116 E 11TH St Ste 101
Spencer, IA 51301-4365
Phone (712) 264-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190416002420 IA Practitioner - Physician Assistant 6204177462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Municipal HospitalGroup PAC ID 4183533060, 95 clinicians

Practice addresses (Care Compare)

101 E 10TH St
Suite 208
Spencer, IA 51301-4307
Phone (712) 264-6189

116 E 10TH St
Suite 101
Spencer, IA 51301-4365
Phone (712) 264-3500

1200 1St Ave E
Spencer, IA 51301-4342
Phone (712) 264-6198

1200 1St Ave E C
Nwia Bone Joint and Sports Surgeons
Spencer, IA 51301-4342
Phone (712) 262-7511

2004 Okoboji Ave
Milford, IA 51351-1271
Phone (712) 338-2461

231 N 8TH Ave W
Hartley, IA 51346-1077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital CurrentSince Mar 24, 2019 Accepting new patients
Spencer Municipal Hospital CurrentSince Mar 24, 2019 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital Past Accepting new patients

Locations

2004 Okoboji Ave
Milford, IA 51351
Phone (712) 338-2461

101 E 10th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

116 E 11th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

Interoperability endpoints

  • Direct secure messaging: edwin.suaza@avera.sdhealthlink.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1982161204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E 11TH ST STE 101",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014365",
            "telephone_number": "712-264-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E 11TH ST STE 101",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014365",
            "telephone_number": "712-264-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAZA",
        "first_name": "EDWIN",
        "middle_name": "FRANCISCO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

Verify at the official NPI Registry.